| NPI | 1710268412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IN 01078506A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01078506) |
| 208M00000X Hospitalist (Licence: FL ME113450) | |
| 208M00000X Hospitalist (Licence: WI 73475) | |
| Enumeration Date | 2011-09-08 |
| Last Update Date | 2021-06-29 |